Health Profile Transitions and the Association With Cognitive Impairment in Older Nursing Home Residents With Suicidal Ideation

IF 3.6 3区医学 Q2 GERIATRICS & GERONTOLOGY

International Journal of Geriatric Psychiatry Pub Date : 2024-10-23 DOI:10.1002/gps.70003

Yiyang Yuan, Adrita Barooah, Kate L. Lapane, Deborah Mack, Anthony J. Rothschild, Christine M. Ulbricht

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引用次数: 0

Abstract

Objectives

In older U.S. nursing home residents with suicidal ideation (SI), limited studies have longitudinally investigated their health changes as related to cognitive function. This study aimed to identify the health profiles and the transitions between profiles at admission and 90-days and examine the associations with cognitive impairment.

Methods

Using Minimum Data Set 3.0 (2011–15), we identified 10,079 older residents without severe cognitive impairment who reported SI on Patient Health Questionnaire-9. Health profile indicators included at-admission and 90-day post-admission depressive symptoms, frailty, and pain frequency and intensity. Using latent transition analysis, we identified distinct health profiles, examined the transitions between profiles over time, and estimated their associations with cognitive impairment.

Results

One third of residents continued to report SI at 90 days. The five health profiles identified at admission were distinctive with varying levels of frailty, depressive symptoms, and pain, from the most severe Profile 1 characterized by frailty, all depressive symptoms, and horrible or frequent pain, to the least severe Profile 5 characterized by pre-frailty, depressed mood, and no pain. The 90-day profiles were mostly consistent. Most residents remained in a similar profile over time. Relative to residents with intact cognition/mild cognitive impairment, those with moderate impairment were less likely to belong to profiles characterized by more depressive symptoms and pain.

Conclusions

Residents with SI had heterogeneous health profiles, which varied by cognitive impairment levels, but showed minimal changes despite being in a medically supervised setting. Findings highlighted the critical need for adequate recognition and management of SI in nursing homes.

查看原文本刊更多论文

有自杀倾向的养老院老人的健康状况转变及其与认知障碍的关系。

研究目的对于有自杀意念（SI）的美国老年疗养院居民，纵向调查其健康变化与认知功能相关性的研究非常有限。本研究旨在确定入院时和 90 天后的健康状况以及健康状况之间的转变，并研究其与认知障碍之间的关联：利用最小数据集 3.0（2011-15 年），我们确定了 10,079 名无严重认知障碍且在患者健康问卷-9 中报告了 SI 的老年居民。健康状况指标包括入院时和入院后 90 天的抑郁症状、虚弱程度、疼痛频率和强度。通过潜伏转换分析，我们确定了不同的健康状况，研究了不同健康状况之间随时间的转换，并估计了它们与认知障碍之间的关系：三分之一的住院患者在 90 天后仍报告存在 SI。入院时确定的五种健康状况各具特色，虚弱程度、抑郁症状和疼痛程度各不相同，从最严重的健康状况 1（以虚弱、所有抑郁症状和严重或频繁疼痛为特征）到最不严重的健康状况 5（以前期虚弱、情绪低落和无疼痛为特征）。90 天的情况基本一致。大多数住院患者在一段时间内都保持着相似的特征。与认知功能完好/轻度认知功能受损的住院患者相比，中度认知功能受损的住院患者较少出现抑郁症状和疼痛：患有系统性损伤的住院患者的健康状况各不相同，因认知障碍程度而异，但尽管处于医疗监管环境中，他们的健康状况却变化甚微。研究结果凸显了在养老院中充分识别和管理侵入性疾病的重要性。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

International Journal of Geriatric Psychiatry 医学-精神病学

CiteScore

6.10

自引率

2.50%

发文量

168

审稿时长

4-8 weeks

期刊介绍： The rapidly increasing world population of aged people has led to a growing need to focus attention on the problems of mental disorder in late life. The aim of the Journal is to communicate the results of original research in the causes, treatment and care of all forms of mental disorder which affect the elderly. The Journal is of interest to psychiatrists, psychologists, social scientists, nurses and others engaged in therapeutic professions, together with general neurobiological researchers. The Journal provides an international perspective on the important issue of geriatric psychiatry, and contributions are published from countries throughout the world. Topics covered include epidemiology of mental disorders in old age, clinical aetiological research, post-mortem pathological and neurochemical studies, treatment trials and evaluation of geriatric psychiatry services.